New rules to allow some gay & bi men to donate blood

Recommendations from the FAIR (For the Assessment of Individualised Risk) steering group, to enable a more individualised way of assessing safe blood donations, were accepted in full by the Department of Health & Social Care last month, which means men who have sex with men (MSM) in a long-term relationship will be able to give blood from summer 2021.

Led by NHS Blood and Transplant (NHSBT), FAIR – a collaboration of UK blood services, Public Health England, University of Nottingham and LGBTQ+ / sexual health charities, including Terrence Higgins Trust (THT), National AIDS Trust (NAT) and Stonewall – came together in 2019 with a shared determination to lead the change towards a more individualised risk assessment for donation.

The group’s analysis concluded that changes can be made to the donor health check questionnaire to allow the introduction of new behaviour-based deferrals, which the group says is a fairer way to maintain blood safety. People are asked to complete the health check questionnaire before they donate to assess eligibility and ensure the safety of both donor and patient.

When the changes come into effect in summer 2021, any individual who attends to give blood – regardless of gender or sexuality – will be assessed for eligibility against these sexual behaviour risks and deferred if found to be at a higher risk of infection.

The biggest change will mean anyone who has the same sexual partner for more than three months will be eligible to donate if there is no known exposure to an STI or use of PreP or PEP. Donors will no longer be asked to declare if they have had sex with another man, making the criteria for blood donation gender neutral and more inclusive. A set of other deferrals will also be introduced for the other higher risk sexual behaviours identified, such as if a person recently had chemsex, and updated for anyone who has had syphilis.

FAIR concluded that this new deferral system will maintain the safe supply of blood in the UK, where there’s a less than one in a million chance of not-detecting a hepatitis B, C and HIV infection in a donation.

Dr Michael Brady

Dr Michael Brady, medical director at THT, said: "Our first priority must be to ensure the safety of the blood supply in the UK. We welcome the move to a more individualised risk assessment approach to blood donation. There is certainly more work to do; we will continue to work to ensure that our blood donation service is inclusive, evidence-based and both maximises the numbers who can donate while ensuring our blood supply is safe."

Nancy Kelley

Nancy Kelley, chief executive of Stonewall, said: "This change represents an important first step towards a donation selection policy entirely based on an individualised assessment of risk. We will continue to work with government to build on this progress and ensure that more people, including LGBTQ+ people, can donate blood safely in the future."

Deborah Gold

Deborah Gold, chief executive of NAT, said:“We now need to see action on the endemic health inequalities that lead to the disproportionate impact of HIV on some groups including gay and bisexual men and people from black African communities. This includes government meeting its commitment to end new HIV transmissions by 2030 and implementing the findings of the HIV Commission, which set out how this can be achieved.”

To see the FAIR recommendations in full: www.blood.co.uk/news-and-campaigns/newsand-statements/fair-steering-group/

More info on THT: www.tht.org.uk

More info on NAT: www.nat.org.uk

More info on Stonewall: www.stonewall.org.uk